WELCOMEESTARS Mission Statement...

"The vision of the Endovascular Skills for Trauma and Resuscitative Surgery (ESTARS) working group is to advance the effective research, development and application of endovascular technologies for use in the setting of trauma and resuscitative surgery. To this end, the ESTARS working group advocates for permeation of the endovascular skill set to providers knowledgeable about and committed to trauma care and emergency surgery while anticipating and working to address challenges inherent to a diverse interdisciplinary environment."

Vision Statement

Endovascular Skills for Trauma and Resuscitative Surgery (ESTARS) has been established to advance the effective research, development and application of endovascular technologies for use in the setting of trauma and resuscitative surgery. ESTARS advocates for permeation of the endovascular skill set to providers knowledgeable about, and committed to trauma care and emergency surgery while anticipating and working to address challenges inherent to a diverse interdisciplinary environment.

Challenge

To maintain the high standard of care of those sustaining blunt aortic and central vascular injuries, in a training environment where the number of open vascular procedures for general surgical residents has decreased, but endovascular procedures in trauma have increased. ESTARS was formed to train and encourage trauma surgeons to adopt the endovascular skill set, and seeks to address these objectives:

1. Assure that the management of vascular injury is a required element of new vascular and acute
    care surgery training programs.
2. Promote a basic endovascular skill set to the trauma and acute care surgery communities.

Cervical Trauma

Vascular Injury within the cervical region can be devastating due to the close proximity of several vital structure – the airway, blood supply to the brain as well as the spinal cord. Endovascular surgery has revolutionized the management of vascular injury in difficult to reach regions of the neck such as the Zone III injuries near the base of skull. Endovascular techniques can be used to either control bleeding in order to permit un-hurried open access, or to stent arterial injuries in order to restore blood flow.

Extremity Vascular Trauma

This can result in mortality from exsanguinating hemorrhage or lifelong disability if an interrupted blood supply is not restored. Endovascular surgery has a role in both extremity hemorrhage control as well as the subsequent reconstruction. Endovascular techniques coexist with other adjuncts such as shunts that make up the modern vascular trauma armamentarium.

Torso Trauma

Exsanguinating non-compressible torso hemorrhage is the leading cause of potentially preventable trauma deaths. Hemorrhage leads to cardiovascular collapse and death unless myocardial and cerebral perfusion can be maintained. Traditionally, torso hemorrhage control has been achieved operatively, which requires both anesthetic and surgical facilities. The majority of patients with torso hemorrhage die prior to hospital, and even those surviving to admission are often in extremis.

One of the most potentially important innovations in endovascular trauma management is the development of resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct to torso hemorrhage control. This technique can be instituted prior to the Operating Room and augments afterload, supporting the myocardial and cerebral circulations while controlling arterial inflow to the distal circulation where vascular disruption has occurred.